Utilization Management RN - Acute Care (Day, Onsite) Sign-On Bonus

Wellstar Health System, Inc.; Martinez (GA); On-site; USD 80,000 - 105,000; Full time

Benefits offered by this job

Sign on bonus

Relocation assistance

Job summary

Wellstar Health System, Inc. at Cobb Hospital is seeking a Utilization Management (UM) Nurse with strong clinical knowledge and at least 3 years of experience.

The role conducts medical necessity reviews using Indicia criteria and collaborates with physicians to coordinate safe transitions of care. This FT Days, onsite position requires obtaining timely authorizations, documenting in EPIC, and supporting post-discharge planning.

Qualifications

• Graduate of an accredited/approved school of nursing required.
• Bachelor's Degree in nursing (BSN) preferred.
• RN license (single state) required.

Responsibilities

• Assess necessity and appropriateness of health services using established screening criteria (e.g. MCG).
• Initiates assessment for necessity and appropriateness of health services by screening criteria.
• Provides required information to payors and obtains appropriate authorization for all days.
• Monitors and evaluates patient care plans and conducts timely concurrent reviews.
• Communicates with providers and payors to resolve discrepancies and ensure timely through-put.

Skills

Clinical knowledge

Communication skills

Documentation

Case management

Interdisciplinary collaboration

Computer skills

Education

Registered Nurse license (RN) - single state

Bachelor's Degree in Nursing (BSN)

Job description

Wellstar Health System, Inc. at Cobb Hospital is seeking a Utilization Management (UM) Nurse with strong clinical knowledge and at least 3 years of experience.

The role conducts medical necessity reviews using Indicia criteria and collaborates with physicians to coordinate safe transitions of care. This FT Days, onsite position requires obtaining timely authorizations, documenting in EPIC, and supporting post-discharge planning.